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Objective: To evaluate MDCT perfusion role in HCC local therapy response. Patients and methods: Post radiofrequency ablation and trans-arterial chemoembolization 14 (88%) male and 2 (12%) female HCC patients; with the mean age, 55.75 ± 10.6 years underwent follow-up hepatic CT perfusion. The hepatic arterial and portal venous perfusions (HAP and HPP, ml/min/100 ml) and hepatic perfusion index (HPI%) were indicated using the color coded maps to assess the effects of local therapy on hepatic perfusion values. Results: The post local treatment CTP of the recurrent tumor confirmed relative increased HAP and HPI and reduced PVP relative to the background values of the cirrhotic hepatic parenchyma. The recurrent HCC post-treatment CTP including HAP is 71 ± 12.19, the PVP is 25.5 ± 8.66 and HPI is 52.5 ± 11.9. The post local-treatment CTP of the necrosis confirmed relative decreased HAP and HPI and increased PVP. The post-treatment necrosis CTP including HAP is 23 ± 10.39, the PVP is 34.75 ± 11.5 and HPI is 29 ± 16.51. The CTP sensitivity is 75%, specificity 50% and P-value